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Vestibular Imbalance Associated With a Lesion in the Nucleus Prepositus Hypoglossi Area
Sang Won Seo, MD;
Ha Young Shin, MD;
Seo Hyun Kim, MD;
Sang Won Han, MD;
Kyung Yul Lee, MD;
Seung Min Kim, MD;
Ji Hoe Heo, MD, PhD
Arch Neurol. 2004;61:1440-1443.
Background The nucleus prepositus hypoglossi (NPH) is known to be a neural integrator of horizontal eye movements. Although the role of the human NPH is not well known, it may also function in postural balance, in view of its anatomic connections with the vestibular nuclei and vestibulocerebellum and of lesion studies in experimental animals.
Objective To show that the human NPH contributes to vestibular function in addition to eye movement control.
Design Case series.
Setting University hospital.
Patients Six patients with small and discrete brainstem infarctions that predominantly involved the NPH region.
Main Outcome Measure Findings on magnetic resonance images.
Results The NPH was affected at the lower pontine level in 2 patients and at the upper medullary level in 4. In addition to gaze-evoked nystagmus, all patients had vertigo, vomiting, and postural ataxia, suggesting vestibular dysfunction. The patients typically fell contralaterally or bilaterally to the lesion side.
Conclusion The NPH serves a vestibular function in addition to its oculomotor control function.
Author Affiliations: From the Department of Neurology, Brain Research Institute, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.
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ABSTRACT
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